枸橼酸钠抗凝在出血性血液透析患者中的应用效果.docVIP

枸橼酸钠抗凝在出血性血液透析患者中的应用效果 　　[摘要] 目的 探讨枸橼酸钠抗凝在出血性血液透析患者中的应用效果及护理干预措施。 方法 选取本院2012年6月～2013年12月收治的22例出血性血液透析患者为研究对象，随机将其分为两组，各11例，对照组采取肝素抗凝，观察组采用枸橼酸钠抗凝，对两组凝血情况、电解质浓度及不良反应等进行比较。 结果 观察组透析过程中未出现出血情况，对照组透析过程中出现4次出血。两组患者的尿素清除指数、尿素氮减少率、超滤量比较差异无统计学意义（P0.05）。观察组患者治疗后Na+、pH值明显高于对照组，差异有统计学意义（P0.05）。 结论 血液透析中应用枸橼酸钠效果显著，安全有效，同时加强枸橼酸钠抗凝的护理干预，可以充分发挥其在出血性血液透析中的抗凝作用。 　　[关键词] 出血性；血液透析；枸橼酸钠；抗凝；护理 　　[中图分类号] R459.5 [文献标识码] B [文章编号] 1674-4721（2014）08（a）-0158-03 　　Application effect of sodium citrate as anticoagulant in patients with hemorrhagic hemodialysis 　　WU Xiao-fang 　　Department of Nephrology，People′s Hospital of Liyang City in Jiangsu Province，Liyang 213300，China 　　[Abstract] Objective To explore the application effect of sodium citrate as anticoagulant in patients with hemorrhagic hemodialysis and the nursing intervention measure. Methods 22 cases of patients with hemorrhagic hemodialysis from June 2012 to December 2013 in our hospital were selected and randomly divided into two groups，each group for 11 cases.In control group，the heparin was selected for anticoagulation，while in observation group，sodium citrate was chosen for anticoagulation.The coagulation，electrolyte concentration and adverse reaction of two groups was compared respectively. Results There was no hemorrhage occurred in the process of hemodialysis in the observation group，while in the control group，hemorrhage happened 4 times during hemodialysis.There was no statistical difference in urea clearance index，decrement rate of urea nitrogen and ultrafiltration volume in two groups（P0.05）.In addition，the value of sodion and pH after treatment in observation group was higher than that in control group respectively，with statistical difference（P0.05）. Conclusion In the process of hemodialysis，application of sodium citrate can obtain a remarkable effect，which is safe and effective.At the same time，strengthen the nursing intervention sodium citrate anticoagulation can give full play to its anticoagulant role in hemorr